Question of the Week
November 29, 2004


From the time that AIDS was first being diagnosed in 1981,

"The estimated number of diagnoses of AIDS through 2002 in the United States is 886,575. Adult and adolescent AIDS cases total 877,275 with 718,002 cases in males and 159,271 cases in females. Through the same time period, 9,300 AIDS cases were estimated in children under age 13."

Please note: These numbers are estimates, only through 2002, and only refer to cases with an AIDS diagnosis--not a diagnosis of HIV.

So, how many people have HIV in the United States?

"[As of the year 2000], [t]he Centers for Disease Control and Prevention (CDC) estimate that 850,000 to 950,000 U.S. residents are living with HIV infection, one-quarter of whom are unaware of their infection.
"Approximately 40,000 new HIV infections occur each year in the United States, about 70 percent among men and 30 percent among women. Of these newly infected people, half are younger than 25 years of age."

While HIV is the virus that causes AIDS, not everyone with HIV has had the disease progress to the point of AIDS.

"The AIDS case definition used for surveillance in the United States was updated by the CDC in 1992. Initially, the definition was based almost exclusively on the diagnosis of one or more "defining illnesses," i.e., opportunistic infections that were unique to AIDS. However, advocates argued that this resulted in undercounting of women, whose AIDS-related illnesses were not unique to AIDS (e.g., cervical cancer and chronic dysplasia). This was particularly problematic because many government programs based their eligibility on an AIDS diagnosis; thus, many women were dying of AIDS without qualifying for any AIDS-related services. The new definition added CD4 T-cell counts, a common marker for assessing AIDS-related immune system damage. The formal AIDS diagnosis now includes all HIV-infected adults and adolescents with a CD4 T-cell count below 200 or who have been diagnosed with pulmonary tuberculosis, invasive cervical cancer, recurrent pneumonia, HIV encephalopathy, chronic isosporiasis, disseminated histoplasmosis, wasting syndrome, or other conditions."

Early treatment is key in slowing the progression of HIV to AIDS; but early treatment requires that people know that they have the disease and that they begin to take action.

"With the advent in the late 1990s of powerful new AIDS treatments, called highly active anti-retroviral therapy (HAART), the limits of AIDS reporting became even more pronounced. With increasing numbers of people receiving early treatment for HIV and forestalling progression to AIDS, reporting of AIDS cases became an increasingly imprecise representation of the epidemic. In response, many states began moving toward reporting HIV diagnoses in addition to AIDS case reporting."

While (with early diagnosis and the help of powerful medications) people are living longer with HIV, AIDS is still a reality. There is not yet a cure for HIV or AIDS. We still have an epidemic. Those in the US are clearly not exempt, but AIDS has been far more devastating globally than what most U.S. residents have observed in our neighborhoods.

"Worldwide, approximately 11 of every 1000 adults aged 15 to 49 are HIV-infected. In Sub-Saharan Africa, about 7.5 percent of all adults in this age group are HIV-infected. Women account for nearly half of all people worldwide living with HIV/AIDS."

How many people are in your school? How many adults (and teens) are in your city or state? Work with the global numbers. What if you lived in Sub-Saharan Africa? How would this affect your neighborhood? Work with the numbers for the United States listed earlier. How does this compare? To put some of these statistics in perspective, you can find current local, national, and global population estimates at:

However the numbers work out for your community (keeping in mind that each community is different, and some areas--even in the U.S.--have higher HIV/AIDS population densities than others), the global numbers are tragic.

"At the global level, the number of people living with HIV continues to grow - from 35 million in 2001 to 38 million in 2003.
"An estimated 5 million people acquired the human immunodeficiency virus (HIV) in 2003, the greatest number in any one year since the beginning of the epidemic.
"In 2003, almost three million were killed by AIDS; over 20 million have died since the first cases of AIDS were identified in 1981."

Worldwide, the decision still must be made: When does an HIV diagnosis become AIDS?

"Outside of the United States, many countries use one of two World Health Organization (WHO) case definitions for AIDS. The WHO "AIDS surveillance case definition" is recommended in cases where there is limited access to HIV serology testing. It defines AIDS (for adults or adolescents over 12 years of age) as having at least two of the "major signs" and at least one of the "minor signs" of the disease."

The bottom line:

"AIDS is the worst epidemic humankind has ever faced. The virus infects 14,000 people every day, leaving millions of people suffering and having a devastating effect on the world's most vulnerable:
"More than 14 million children worldwide have been orphaned because of AIDS. That's the equivalent of every child under five in America with no one to watch over them.
"Nearly six million children have been killed by AIDS. That number is more than every child in every grade school and high school in New York, Los Angeles, Chicago, Washington, Miami and Atlanta combined."

HIV does not discriminate: male, female, young, old, and if you are between the ages of 15 and 24:

"Today, more than half of those newly infected with HIV/AIDS are between the ages of 15 and 24, and in some countries, one out of every four people is infected with the disease. ... Sadly, if nothing is done, countries all over the globe will face ever-increasing death rates that will decimate workforces, economies, life expectancy rates, and living standards, and even more tragically, leave millions of young children without parents. Eventually, every country will be severely affected by a global disaster of this magnitude."

Progress can be made if the disease is taken seriously.

"In Uganda, HIV infection rates have fallen for the eighth straight year from 29.5 percent in 1992 to only 11.25 percent in 2000. This is a direct result of communication programs that reach down to the village level."

While 11.25 percent is still a devastating number, it is certainly a drastic improvement showing strides in the right direction.

To contrast, in the United States...

"The estimated number of new adult/adolescent AIDS diagnoses in the United States was 43,225 in 1998, 41,134 in 1999, 42,239 in 2000, 41,227 in 2001, and 42,136 in 2002."

... things have pretty much stayed the same.

Questions of the Week:
How severe will the problem have to get here in the U.S. before it is taken seriously by more people? What is the difference between an HIV diagnosis and a diagnosis of AIDS? How can a patient benefit from finding out they have HIV in it's early stages? With an estimated hundreds of thousands of people (in the U.S. alone) unaware that they have AIDS, what can teens (and adults) do to protect themselves and reduce their risks of acquiring the disease? Look over the numbers. Work with the math. How could HIV and AIDS be affecting your community?

Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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